目的:中国缺乏原发性硬化性胆管炎(PSC)的流行病学。我们旨在评估中国PSC的经期患病率并描述其临床特征。
方法:我们从电子病历(EMR)和系统文献检索(SLR)两个来源确定并纳入了2000年至2023年的PSC病例。通过乘数法估计PSC的时期患病率。通过负二项回归模型计算PSC患病率与宏观经济指标的比率(RR)。
结果:从299家医院共检索到1358例PSC病例(162例来自EMR,1196例来自SLR)。男性占PSC病例的55.7%,并伴有炎症性肠病(IBD)的占25.7%。从2000年到2023年,PSC的估计患病率为每100,000人中2.36(95%CI:1.82,3.34)。男性的PSC患病率高于女性(2.56,95%CI:1.97,3.63vs.2.14,95%CI:1.65,3.04/100,000)。PSC患病率最高的是华东地区,为4.87(95%CI:3.44,7.18)/10万,其次是华北地区,为2.94(95%CI:2.33,3.74)/10万,华南地区最低,为0.92(95%CI:0.66,1.30)/10万。地区人均GDP(RR1.65,95%CI:1.03,2.65)和医疗保健支出(RR1.94,95%CI:1.13,3.38)被确定为与PSC患病率相关。
结论:我们的研究表明,中国估计的PSC患病率各不相同,但总体上低于西方国家。
OBJECTIVE: Epidemiology of primary sclerosing cholangitis (PSC) is lacking in
China. We aimed to estimate the period prevalence and depict the clinical features of PSC in
China.
METHODS: We identified and included PSC cases between 2000 and 2023 from two sources: electronic medical records (EMR) and systematical literature retrieval (SLR). The period prevalence of PSC was estimated by the multiplier method. Rate ratios (RRs) for PSC prevalence in relation to macroeconomic indicators were calculated by the negative binomial regression model.
RESULTS: A total of 1358 PSC cases were retrieved from 299 hospitals (162 from EMR and 1196 from SLR). Males accounted for 55.7 % of the PSC cases and 25.7 % had concomitant inflammatory bowel disease (IBD). The estimated period prevalence of PSC from 2000 to 2023 was 2.36 (95 % CI: 1.82, 3.34) per 100,000. Males had a numerically higher PSC prevalence than females (2.56, 95 % CI: 1.97, 3.63 vs. 2.14, 95 % CI: 1.65, 3.04 per 100,000). The highest prevalence of PSC was in East
China at 4.87 (95 % CI: 3.44, 7.18) per 100,000, followed by North
China at 2.94 (95 % CI: 2.33, 3.74) per 100,000, and the lowest in South
China at 0.92 (95 % CI: 0.66, 1.30) per 100,000. Regional per capita GDP (RR 1.65, 95 % CI: 1.03, 2.65) and healthcare expenditure (RR 1.94, 95 % CI: 1.13, 3.38) were identified to be associated with PSC prevalence.
CONCLUSIONS: Our study showed the estimated PSC prevalence varied within
China, but was generally lower than that in Western countries.